Some 17% of people living in the U.S., or more than 1 in 6, were 65 or older in 2020. By 2040, there will be about 80.8 million people 65 and older in the country, making up about 22% of the population, according to a report from the Administration on Aging.
This "silver tsunami," as it is often referred to, is opening up opportunities for companies that provide services and products to support healthy aging for older adults and improve seniors' lifespans.
Los Angeles-based Bold banked $17 million in a series A funding round to build up its virtual exercise programs for aging adults. The startup developed personalized, evidence-based exercise programs for Medicare members that help prevent falls, reduce musculoskeletal pain and disability and increase physical activity levels.
Amanda Rees, an engineer by background, was inspired to build and launch the startup based on her personal experience serving as a caregiver to her grandmother while in her 20s.
"It really was a gift in so many ways because it changed the way I thought about aging and it gave me a very different perspective of the healthcare system," Rees told Fierce Healthcare.
Rees helped to navigate her grandmother's healthcare journey which included recovering from falls, facing stage four cancer and dementia and transitioning in and out of the hospital and hospice care. Along the way, Rees saw the need for solutions and services focused more on preventive care.
"I thought we didn't have the solutions that I would have hoped to see and that I would hope that, by the time I am fortunate enough to be that age, would exist to keep someone healthy and from having the fall or the injury or the chronic condition," she said. "I was surprised to see how much evidence, science and research exists but it seems that no one had taken that science and evidence and built consumer-focused products that actually put the agency into an individual's hands."
"We thought, how can we design the tools, services and support that would actually close that gap between how long we're living and how healthy we are," she said, noting that there is a growing disconnect between quality of life and overall longevity for older adults. "It's that lifespan-healthspan gap that we're focused on," she added.
Rees also has a background in dance and knows the power of movement, so building a startup around "movement-as-medicine" brings together her diverse interests and expertise, she noted.
Bold's series A funding was led by Rethink Impact, with participation from Samsung Next and existing investors Andreessen Horowitz (a16z) Bio + Health, Khosla Ventures, GingerBread Capital, and Primetime Partners. The startup has raised $27 million to date.
The capital will be used to support Bold’s continued expansion with national and regional Medicare plans and provider groups and accelerate the growth of its clinical exercise offerings to support the diverse physical and mental health needs of older adults. More than 10 million Medicare members now have access to Bold’s platform, according to the company. "The organizations that we work with reflect about 50% of all Medicare Advantage members," Rees said.
Bold provides each member with a personalized, evidence-based exercise program in order to prevent falls, reduce musculoskeletal pain and disability, and increase physical activity levels. The company partners with innovative Medicare plans and providers to support underserved members, many of whom suffer from chronic conditions, mobility issues and pain, Rees noted. The accessible, easy-to-follow, virtual programs that are designed to improve strength and balance and promote lifelong well-being.
Utilizing dynamic adjustments and sophisticated behavioral science, Bold’s platform engages members continuously with a goal of building sustainable habits and not just short-term recovery, she said.
Less than 15% of older adults in the U.S. meet the recommended physical activity guidelines, according to a federal report. Four out of 5 of the most costly chronic conditions among adults 50 years or older can be prevented or managed with physical activity, data from the Centers for Disease Control and Prevention shows.
Medicare Advantage plans and providers are investing in programs and services to support healthy aging as falls and injuries drive high healthcare costs.
More than one out of four older people falls each year, according to CDC data, and that results in $50 billion in medical costs. Medicare plans spend more on falls than on cancer, Rees noted.
"What we've been able to demonstrate over time, both in our partnerships and in research that we've published, is not only can we reduce falls and fall-related hospitalizations, but we also can reduce pain, and we can change how much someone is physically active," she said.
Bold published a study in the Journal of Medical Internet Research that showed a link between participation in Bold's program and a 46% reduction in falls as well as a 182% increase in members' weekly physical activity levels.
Bold also boasts a 91% member satisfaction rate and nearly 8 of 10 members would be more likely to choose a Medicare plan that offers Bold, according to the company.
"What I'm excited about actually in this space is when we first were building and sort of getting off the ground, there was so much disbelief around older adults being digitally connected," Rees said. "We now get far fewer eyebrows raised around building something digital-first for older adults. I think there's a lot of consumer preference to be met in a digital-first way and I think we would have just built the solution that the moment is really looking for."
Rees also believes that companies like Bold are changing the conversation around aging. "The wonderful thing about exercise is it lends itself to engagement. There's always a reason to get someone moving. Our focus is how do we get someone moving and then keep them moving. And, we're not afraid to talk about aging. I think that's something that's not just specific to Medicare, it's a broader piece of, how do we talk about aging? Do we feel like we have agency around how we're aging? Those are things we've thought about as we've worked with members across our platform."
“Bold is at the forefront of a new paradigm in preventive health care for older adults that is founded in deep empathy for members and a thorough understanding of cutting-edge health science,” said Jenny Abramson, founder and managing partner of Rethink Impact, who is joining Bold’s Board of Directors. “As the nation’s population continues to age and Medicare costs balloon, we desperately need innovative, evidence-based solutions like Bold that meet people where they are and drive value across the healthcare system, from members to providers to payers.”
There are other startups focused on improving the health of aging seniors or helping them navigate healthcare benefits. Mighty Health is a personal health coach that offers joint-friendly, low-impact workouts for healthy aging and raised $7.6 million back in January. Mighty Health partners with Medicare Advantage and commercial health plans to cover over nine million patients nationwide, the company said.
Senior care startup Duos provides seniors benefit navigation services. The startup, which raised $15 million back in April, connects older adults and their caretakers to a network of service providers to help members with their social needs, care navigation needs and physical aging needs.
Fair Square Medicare launched in 2020 to help older adults find health insurance plans to best fit their healthcare needs. An alum of the YCombinator startup accelerator, the company leverages technology to provide better services for a new generation of seniors who are used to a seamless digital customer experience. The startup banked a $15 million series A round in August 2022.